Literature DB >> 20725881

Whole-heart 320-row computed tomography: reduction of radiation dose via prior coronary calcium scanning.

E Zimmermann1, M Dewey.   

Abstract

PURPOSE: The whole heart can be scanned in one rotation using 320-row coronary computed tomography angiography (CCTA), which covers up to 16 cm. Since most hearts are smaller, the total radiation dose may be reduced by adjusting the CCTA range to the individual heart size defined on a low-dose calcium scan (CACS).
MATERIALS AND METHODS: Forty-five patients with suspected coronary artery disease (13 women, 32 men; mean 61 ± 10 years) underwent CCTA preceded by low-dose CACS on a 320-row scanner (Aquilion ONE, Toshiba; 0.35 s gantry rotation, 120 kV, 350 - 450 mA) with 16-cm z-axis coverage (120 kV, 150 mA). The subsequent CCTA was performed over an adjusted scan range calculated as the individual heart size on CACS (+ 1 cm above and below). The total radiation dose of 16-cm CACS and the individually adjusted CCTA was compared with that of a calculated single CCTA using full 16-cm z-axis coverage.
RESULTS: CCTA could be performed with a reduced scan length in the z-axis in all patients. None of the scans had to be performed over the whole range of 16 cm. The adjusted scan length was 14 cm in 2 patients, 12.8 cm in 3 patients, and 12 cm in 40 patients. The effective CCTA scan range was 12.1 ± 0.5 cm based on mean individual heart sizes of 9.6 ± 1.1 cm. The mean total effective radiation dose of the entire cardiac CT examination (individually adapted CCTA and CACS) was significantly smaller than the exposure calculated for 16-cm CCTA without CACS (8.5 ± 4.7 vs. 9.1 ± 6.0 mSv, p = 0.006). The dose reduction was most relevant in patients with heart rates above 65 beats/min (n = 10) in whom 2 or 3 heartbeats were necessary for CCTA (17.7 ± 6.5 vs. 21.1 ± 8.4 mSv, p = 0.001).
CONCLUSION: 320-row CCTA with an individually adjusted scan range based on prior CACS significantly reduces the radiation exposure compared with full 16-cm CCTA. © Georg Thieme Verlag KG Stuttgart · New York.

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Year:  2010        PMID: 20725881     DOI: 10.1055/s-0029-1245629

Source DB:  PubMed          Journal:  Rofo        ISSN: 1438-9010


  6 in total

Review 1.  Established and emerging dose reduction methods in cardiac computed tomography.

Authors:  Gary R Small; Mustapha Kazmi; Robert A Dekemp; Benjamin J W Chow
Journal:  J Nucl Cardiol       Date:  2011-08       Impact factor: 5.952

2.  Quantification of radiation dose reduction by reducing z-axis coverage in 320-detector coronary CT angiography.

Authors:  David J Murphy; Abhishek Keraliya; Nathan Himes; Ayaz Aghayev; Ron Blankstein; Michael L Steigner
Journal:  Br J Radiol       Date:  2017-06-14       Impact factor: 3.039

3.  Latest-generation catheterization systems enable invasive submillisievert coronary angiography.

Authors:  E Kuon; K Weitmann; A Hummel; M Dörr; T Reffelmann; A Riad; M C Busch; S B Felix; W Hoffmann; K Empen
Journal:  Herz       Date:  2013-12-08       Impact factor: 1.443

4.  When do we really need coronary calcium scoring prior to contrast-enhanced coronary computed tomography angiography? Analysis by age, gender and coronary risk factors.

Authors:  Gitsios Gitsioudis; Waldemar Hosch; Johannes Iwan; Andreas Voss; Edem Atsiatorme; Nina P Hofmann; Sebastian J Buss; Stefan Siebert; Hans-Ulrich Kauczor; Evangelos Giannitsis; Hugo A Katus; Grigorios Korosoglou
Journal:  PLoS One       Date:  2014-04-08       Impact factor: 3.240

5.  Evaluation of computed tomography in patients with atypical angina or chest pain clinically referred for invasive coronary angiography: randomised controlled trial.

Authors:  Marc Dewey; Matthias Rief; Peter Martus; Benjamin Kendziora; Sarah Feger; Henryk Dreger; Sascha Priem; Fabian Knebel; Marko Böhm; Peter Schlattmann; Bernd Hamm; Eva Schönenberger; Michael Laule; Elke Zimmermann
Journal:  BMJ       Date:  2016-10-24

6.  Coronary artery calcium score scan at 100 kVp with tin filtration (Sn100 kVp) prior to coronary computed tomography angiography for overall radiation dose reduction: a prospective cohort study.

Authors:  Liang Jin; Kun Wang; Ming Li
Journal:  Quant Imaging Med Surg       Date:  2022-09
  6 in total

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